Child's Nervous System

, Volume 35, Issue 1, pp 157–163 | Cite as

Infant/toddler motor skills as predictors of cognition and language in children with and without positional skull deformation

  • Brent R. CollettEmail author
  • Erin R. Wallace
  • Deborah Kartin
  • Matthew L. Speltz
Original Paper



To estimate associations between early motor abilities (at two age points, 7 and 18 months on average) and cognitive/language outcomes at age 3. To determine whether these associations are similar for children with and without positional plagiocephaly and/or brachycephaly (PPB).


The Bayley Scales of Infant/Toddler Development 3 were given at all age points to 235 children with PPB and 167 without PPB. Linear regressions assessed longitudinal associations between fine and gross motor scales and cognition/language. Item analyses examined the contributions of specific motor skills.


Associations between 7-month motor skills and cognition/language were modest overall (effect sizes [ES] = − 0.08 to 0.10, p = .13 to .95). At 18 months, both fine and gross motor skills were associated with outcomes for children with PPB (ES = 0.21 to 0.41, p < .001 to .01), but among those without PPB, only fine motor skills were associated with outcomes (ES = 0.21 to 0.27, p < .001 to .001).


Toddlers’ motor skills were associated with cognition and language at 3 years, particularly among children with PPB. Interventions targeting early motor development in infants and toddlers with PPB may have downstream benefits for other outcomes.


Plagiocephaly Brachycephaly Motor skills Infant Development 


Compliance with ethical standards

Conflict of interest

None of the authors have any conflicts of interest to disclose.

Supplementary material

381_2018_3986_MOESM1_ESM.docx (28 kb)
ESM 1 (DOCX 28.4 kb)
381_2018_3986_MOESM2_ESM.docx (25 kb)
ESM 2 (DOCX 24.6 kb)


  1. 1.
    Argenta LC, David LR, Wilson JA, Bell WO (1996) An increase in infant cranial deformity with supine sleep positioning. J Craniofac Surg 7:5–11CrossRefGoogle Scholar
  2. 2.
    Turk AE, McCarthy JG, Thorne CH, Wisoff JH (1996) The “back to sleep campaign” and deformational plagiocephaly: is there cause for concern? J Craniofac Surg. 7:12–18CrossRefGoogle Scholar
  3. 3.
    Hutchison BL, Hutchison LA, Thompson JM, Mitchell EA (2004) Plagiocephaly and brachycephaly in the first two years of life: a prospective cohort study. Pediatrics 114:970–980CrossRefGoogle Scholar
  4. 4.
    Kane AA, Mitchell LE, Craven KP, March JL (1996) Observations of a recent increase in plagiocephaly without synostosis. Pediatrics 97:877–885Google Scholar
  5. 5.
    Collett BR, Leroux BG, Wallace ER, Gallagher E, Shao J, Speltz ML (2018) Head shape at age 36 months among children with and without a history of positional skull deformation. J Neurosurg Pediatr 21:204–213. CrossRefGoogle Scholar
  6. 6.
    Martiniuk A, Jacob J, Faruqui N, Yu W (2016) Positional plagiocephaly reduces parental adherence to SIDS guidelines and inundates the health system. Child Care Health Dev 42:941–950CrossRefGoogle Scholar
  7. 7.
    Collett BR, Gray K, Starr JR, Heike C, Cunningham ML, Speltz ML (2013) Development at age 36 months in children with deformational plagiocephaly. Pediatrics 131:e109–e115CrossRefGoogle Scholar
  8. 8.
    Collett BR, Starr JR, Cunningham ML, Kartin D, Speltz ML (2011) Development in toddlers with and without deformational plagiocephaly. Arch Pediatr Adolesc Med. 165:653–658CrossRefGoogle Scholar
  9. 9.
    Speltz ML, Collett BR, Stott-Miller M, Starr JR, Heike C, Wolfram-Aduan AM, King D, Cunningham ML (2010) Neurodevelopment in deformational plagiocephaly. Pediatrics 125:e537–e542CrossRefGoogle Scholar
  10. 10.
    Bornstein M, Chun-Shin H, Suwalsky JTD (2013) Physically developed and exploratory young infants contribute to their own long-term achievement. Psychol Sci 24:1906–1917CrossRefGoogle Scholar
  11. 11.
    Viholainen H, Ahonen T, Lyytinen P, Cantell M, Tolvanen A, Lyytinen H (2006) Early motor development and later language and reading skills in children at risk of familial dyslexia. Dev Med Child Neurol 48:367–373CrossRefGoogle Scholar
  12. 12.
    Leppig KA, Werler MM, Cann CI, Cook C, Holmes L (1987) Predictive value of minor anomalies. I. Association with major malformations. J Pediatr 110:531–537CrossRefGoogle Scholar
  13. 13.
    Hollingshead AB (1975) Four factor index of social status. Yale University, New HavenGoogle Scholar
  14. 14.
    Bayley N. (2006) Manual for the Bayley Scales of Infant and Toddler Development. 3rd ed. San Antonio: The Psychological CorporationGoogle Scholar
  15. 15.
    Benassi E, Savini S, Iverson JM, Guarini A, Caselli MC, Alessandroni R, Faldella G, Sansavini A (2016) Early communicative behaviors and their relationship to motor skills in extremely premature infants. Res Res Dev Disabil 48:132–144CrossRefGoogle Scholar
  16. 16.
    LeBarton ES, Iverson JM (2016) Associations between gross motor and communicative development in at-risk infants. Infant Behav Dev 44:59–67CrossRefGoogle Scholar
  17. 17.
    Wang MV, Lekhal R, Aarø LE, Schjølberg S (2012) Co-occurring development of early childhood communication and motor skills: results from a population-based longitudinal study. Child Care Health Dev 40:77–84CrossRefGoogle Scholar
  18. 18.
    Iverson JM (2010) Developing language in a developing body: the relationship between motor development and language development. J Child Lang 37:229–261CrossRefGoogle Scholar
  19. 19.
    West KL, Iverson JM (2017) Language learning is hands-on: exploring links between infants’ object manipulation and verbal input. Cogn Dev 43:190–200CrossRefGoogle Scholar
  20. 20.
    Karmiloff-Smith A (2009) Nativism versus neuroconstructivism: rethinking the study of developmental disorders. Dev Psychol 45:56–63CrossRefGoogle Scholar
  21. 21.
    van Vlimmeren LA, Engelbert RHH, Pelsma M, Groenewoud HMM, Boere-Boonekamp MM, Nijhuis-van der Sanden MWG (2017) The course of skull deformation from birth to 5 years of age: a prospective cohort study. Eur J Pediatr 176:11–21CrossRefGoogle Scholar
  22. 22.
    Karmel-Ross K (2012) Congenital muscular torticollis. In: Campbell S, Palisano R, Orlin M (eds) Physical therapy for children, 4th edn. Elsevier/Saunders, St. Louis, p 292–312Google Scholar
  23. 23.
    van Vlimmeren LA, van der Graaf Y, Boere-Boonekamp MM, L’Hoir MP, Helders PJ, Engelbert RH (2008) Effect of pediatric physical therapy on deformational plagiocephaly in children with positional preference: a randomized controlled trial. Arch Pediatr Adolesc Med 162:712–718CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Brent R. Collett
    • 1
    • 2
    Email author
  • Erin R. Wallace
    • 2
  • Deborah Kartin
    • 3
  • Matthew L. Speltz
    • 1
    • 2
  1. 1.Psychiatry and Behavioral SciencesUniversity of WashingtonSeattleUSA
  2. 2.Center for Child Health, Behavior, and DevelopmentSeattle Children’s Research InstituteSeattleUSA
  3. 3.Rehabilitation MedicineUniversity of WashingtonSeattleUSA

Personalised recommendations